Diagnosis and treatment of primary adrenal tumors.

The authors review 21 articles concerning primary adrenal tumors published in 1989. Specifically, the articles deal with the radiologic evaluation of the adrenal mass, functional evaluation of adrenal tumors, technical and perioperative considerations of adrenalectomy, and adrenocortical carcinoma. Several conclusions can be drawn from these recent articles. First, diagnostic accuracy should improve with advances in magnetic resonance imaging and improvements in fine needle aspiration technology. Second, the size of an asymptomatic nonfunctional adrenal mass requiring removal still remains to be definitively determined. Third, adrenocortical carcinomas are generally curable only if small and localized. Finally, adjuvant treatment regimens for more advanced adrenocortical carcinomas using mitotane, suramin, and conventional multiagent chemotherapy need to be evaluated in randomized trials.